Wednesday, March 18, 2009

Why we haven't vaccinated

vaccines and syringes

Several years ago, Sam and I met a new couple at church who had just had their first baby. During our first conversation, and apropos of nothing, they informed us that they weren't vaccinating her.

Sam and I nodded and smiled and edged away, then looked at each other out of their line of sight and mouthed "Cuckoo" while doing the appropriate hand gesture.

OK, I might be exaggerating our response, but we did think they were nuts. We couldn't figure out why not vaccinating was a choice anyone would make. We didn't know people who thought that way existed. Don't vaccinations save lives, and why would we want those icky poor-country diseases around here?

Fast forward to now, and you'll find that we're the crazy ones. I had a very awkward conversation with our 21-month-old toddler's preschool teacher when he looked at our state-mandated vaccination form and found that all we'd signed was the personal exemption on the back. (Washington state is one of the states that allow for an exemption based solely on personal conviction, not religious or medical.) I found out that it's hard to defend your position in a fumbling, three-minute conversation. So far, Mikko's still enrolled, but the teacher advised us that it really is better to vaccinate, you know.

Sigh. I guess I didn't get my point through in my little unprepared speech.

In light of that, I thought I'd try to articulate our position on vaccination. We're actually quite reasonable about it, and not a little ambivalent.

Vaccination is one of those issues that engender a lot of heat, pro and con. People who are for vaccination tend to be heated that people who are against it are ruining the herd immunity and endangering their children. People who are against vaccination are really, really against it, for a whole host of reasons. Of course, then there are the majority of parents, who are for vaccination in a completely unheated, no-duh manner, as counseled by their pediatricians, their own experiences growing up, and, apparently, their children's preschool teachers — everyone gets vaccinated.

It's hard, when you're a new parent, to make sense out of the war between the factions. And it's hard, too, when you just don't care all that much. No, it's true — for me, vaccination was one of those topics I'd rather have just avoided. It sounded so tedious and mind-numbing (and was) to wade through all the hype and jargon and data to try to formulate some sort of conclusion. No one in either of our families had had an acute adverse reaction to a vaccine that we knew of. Many of the diseases the vaccinations are supposed to protect against sounded pretty gnarly but were unfamiliar to me and needed to be researched just as much as the vaccinations themselves.

It made me want to pull my hair out.

But I dutifully checked out books from the library and started scouring websites and asking questions on forums. Our pediatrician is a naturopath who lets parents make their own decisions regarding vaccination, and I really can't figure out where she stands — I appreciate that, but I would have welcomed a little guidance, to be honest.

What I researched only made me more ambivalent — but this time, leaning away from vaccinations, not toward.

I think the first incisive moment was when I was being urged, by state mailings and PSAs, to get a flu vaccine when I was pregnant. I looked into it, which I had never received before, and found out that the flu vaccine had mercury in it. Wait — wasn't I avoiding certain species of fish and varying the type of fish I ate each week specifically to avoid mercury, and now they wanted me to inject it directly into my bloodstream? Does Not Compute (read that in a robot voice, 'k?). Speaking of computing, if you follow those links and I'm doing the math right, the mercury levels in the most toxic fish are around 0.5 parts per million, and the mercury level in the flu vaccine is 50 parts per million. Huh-wha?

The next incisive moment was researching the first vaccine they give a newborn: hepatitis B, spread by bodily fluids. Well, I don't know about you, but I know very few drug-using, promiscuous newborns. By the age they could be dope-dealing hookers, the vaccination's effects have usually worn off. So I really couldn't see what the point of baby hep B vaccines was.

As I read more, I kept a cheat sheet, writing down pertinent facts and my still unanswered questions. I starred the illnesses that scared me more than the vaccine, and I tried to crystallize a position: Was I for or against vaccines? Was I more afraid of the vaccines or more afraid of the illnesses? (Because, no matter which, everyone's position seemed to come down to fear.) Every well-baby visit, our pediatrician would once again ask where we stood and if we wanted vaccines now, and every time I would just keep putting it off. If nothing else, we were following a delayed vaccination schedule, delayed only by my inability to decide what to do.


I found out interesting information as I researched.

     • First of all, the theory that vaccination is what has caused all the harmful diseases to diminish is flawed. The data show that many of the vaccine-preventable diseases were decreasing before widespread vaccine use, and that's probably has much to do with increases in sanitation and clean drinking water.

     • I found out that most recent cases of polio in the U.S. have been from the vaccine (the discontinued, live version).

     • By vaccinating for childhood illnesses like the life-threatening, terrifying chicken pox...wait, chicken pox? Seriously? I had that when I was four and was itchy for a few days and lived to tell the tale. As I was saying...by vaccinating young children against such generally benign illnesses, the onset is being delayed. Because vaccinations are not the same as immunity, and because vaccinations vary widely in how effective they are, we're now going to see outbreaks of chicken pox in adolescence and early adulthood, when the consequences can be much more severe, particularly if pregnant women no longer have immunity. I'd say that all we're doing here is trying to keep mommies at work instead of home with their sick preschoolers, but that might be my jaded sensibilities talking.

     • The ingredients in vaccines will make you blink. Mercury (you've heard the stink about that, presumably), yes, also aluminum, formaldehyde, chicken embryo (when we're cautioned against feeding eggs to our infants), gelatin, MSG, aspartame, aborted fetal tissue — none of them things I relish injecting into my baby's body.

     • Vaccines have outright killed children. Vaccines have given children the diseases they're being immunized against. Vaccinated populations have higher rates of chronic immune conditions.

     • Friends of ours have dutifully gone for their babies' vaccinations and had those babies react acutely. One baby had a high fever and a month-long bout of diarrhea. The kicker: The parents keep going back for the next round! That's how entrenched the value of vaccines has become in the public mind.

     • Perhaps most disturbing to me personally, there have been (disputed) links between vaccines and multiple sclerosis, a degenerative autoimmune disorder that unfortunately runs in my family. No one knows yet what causes MS, but one theory is that there's a genetic element that requires a trigger to start causing symptoms of the disease; that trigger might be immunizations. I would hate to protect my baby from mumps, which in almost all cases is a harmless childhood illness like chicken pox (ask your parents or grandparents), only to have him later develop a debilitating neurological disorder.


As you can see, those were kind of the anti-vaccine rationales. So I'll try to give some "on the other hand" information here:

     • There have been increasing outbreaks of pertussis, also known as whooping cough. It's unclear whether these are natural, periodic outbreaks, or whether it's an argument for or against the herd immunity theory. It is true that pertussis is being diagnosed more often in areas with lower vaccination rates. However, it's unclear whether pertussis is being diagnosed there because doctors are aware of it, as opposed to diagnosing it elsewhere as a cold. Plus, the pertussis vaccine is one of the least effective.

     • Mikko has one testicle, after surgery to remove a damaged one. I have never experienced mumps firsthand but had heard something about potential infertility from mumps. It turns out that mumps can cause glandular swelling, and sometimes one testicle (rarely both) can become swollen and then, rarely also, become sterile. It's usually not an issue, because most guys pack them in pairs, but our little guy doesn't have a backup. The math looks something like this, though: Mumps is rare; swelling is rarer; swelling of testicles is even rarer; sterility as a result of swollen testicles is almost infinitesimally likely. Besides, if he's sterile, he won't have to reproduce and make all these tough vaccination decisions. (Ha ha, little joke — I thought things were getting all stuffy in here. He could always adopt...)

     • Haemophilus influenzae type b scares the pants off me. It's like one of those movie diseases that are being spread by ruthless aliens. Seriously, isn't it ominous sounding? Meningitis occurs in 50-65% of symptomatic cases, and the mortality rate is 2-5%. "In addition, 15%-30% of survivors suffer some permanent neurologic damage, including blindness, deafness, and mental retardation. Another 17% of invasive Hib cases include epiglottitis, an infection and swelling in the throat that can cause life-threatening airway blockage. Other forms of invasive Hib disease include: joint infection (8%), skin infection (6%), pneumonia (15%), and bone infection (2%). ... Even with antibiotic treatment, up to 5% of all children with Hib meningitis die from the disease." However, Hib is rarely life-threatening in children older than five years, in 2002 there were only 34 cases in children in the U.S., and most cases of Hib are seen in the vaccinated population.

     • Rubella can cause severe complications (mental retardation, deafness, and just plain old death) for unborn babies if a pregnant woman is exposed to it. I envisioned a frightening picture of Mikko infecting any future siblings.


So, pros and cons, for and against, weighing our options and weighing them again but not really registering any numbers on the scale. Up till now, we've justified putting off the decision, both because we breastfeed and because Mikko hasn't been exposed much to other children. Now that he's in preschool twice a week, though, I need to reconsider. Bleh. I hate this whole conversation, to be frank.

So, it's back to my research standbys, which I herewith pass on to you:


Vaccinations: A Thoughtful Parent's Guide — Aviva Jill RommBooks:

Two books that helped me jot down basic information about each vaccine and each disease they're supposed to prevent are
Vaccinations: A Thoughtful Parent's Guide, by Aviva Jill Romm, and What Your Doctor May Not Tell You About Children's Vaccinations, by Dr. Stephanie Cave. The former is a little more anti-, and the latter a little more pro-, but they both give a balanced and informed look at the facts. For some reason, I never read The Vaccine Book: Making the Right Decision for Your Child, by Robert Sears, but I keep seeing it recommended as helpful so I'll include it here with a caveat. Because Bob Sears is a Dr. (of the famous attachment-parenting family), he tends to be more pro- as well, but it sounds like he presents the facts so that you can decide.


Forum:

If you have questions about specific vaccines and diseases, or need support in your unorthodox vaccine-delaying ways, head What Your Doctor May Not Tell You About Children's Vaccinations — Stephanie Caveover to Mothering.com's vaccine board and the knowledgeable minds who hang out there. There are specific subcategories for each vaccine/illness, as well as a place for selective and delayed vaccinators to talk freely.


Websites:

Well, I was going to try to find some good ones to list here, but I'm researched out for the day. Post your favorite sites in the comments — for or against vaccination is fine.



If you do choose not to vaccinate, be active in championing your children's health in other ways. First and most importantly, breastfeeding will provide passive immunity. Be aware of the symptoms of the illnesses and their treatments so your child can get any needed medical help. Consider home- or unschooling. Serve your family whole foods, and get some exercise.

If you choose to vaccinate, do all of the above, plus prepare your child for the vaccines. Check your family for any history of adverse reactions, and never vaccinate when your child is even slightly ill, because the immune system needs to be fully functioning to process the vaccines. Read the inserts, set your own immunization agenda (do as few shots at a time as possible, and order the least contaminated versions of each shot), and think twice if your child shows a reaction to a vaccine.


If I were going to give Mikko any vaccines, these are the ones I would consider:
     • pertussis — because of what seems like an unusual spread of whooping cough, and because I don't want to be the bad guy who spread it in the first place (that's not a good reason, I'm realizing as I write it — but isn't so much of vaccine propaganda about peer pressure?)
     • mumps — because of the one-testicled wonder that is our son
     • Hib — because that sucker sounds evil (interesting conversation from someone who thinks the same thing being answered by someone who disagrees)
     • rubella — to protect the as-yet unborn
     • tetanus — because I want Mikko to run around barefoot outside
     • chicken pox — if he hasn't had the disease naturally by adolescence (chicken pox party, anyone?)

But I just don't know. I recoil from the thought of jabbing him with these viruses and toxins. I don't want his life to be in danger, though, from coming into contact with all those germy little babies at his preschool and in the church nursery. I think vaccines are much less effective than we'd like to pretend, and that they can be harmful. On the other hand, they often are innocuous (get the pun?), and the public pressure to vaccinate is great. We're trying to get away from the emotionalism of either side and look at the risks and benefits rationally. Hmm...

Can anyone decide what I think and tell me?

Vaccination photo courtesy of Nick Winchester

26 comments:

Cate said...

Hey there...your new follower here.
I've been researching and blogging about minimally vaccinating, too. My older son is 3.5 and was minimally vaccinated under his ped's recommendation. My younger son is a year and hasn't been vaccinated at all, though his ped did suggest the pertussis reason for the DTP. (I have a 13-year old stepdaughter who brings us fabulous germs from middle school in her spare time.)
But he's not going to be vaccinated. Perhaps, when he's about 3 or 4, we'll decide on a few. But the one main thing about minimally vaccinating, or not at all? Each of these vaccinations were tested for safety (NOT by the FDA, which does such a helluva job, eh?) by the manufacturers. And ONLY one by one. But is that how vaccinations are given? Heck no! Kids are dosed with three or four at each visit. And though there's not mercury in most shots ("no" meaning "trace amounts"!), there are other heavy metals, as you mentioned. And I'm no scientist, but this is what I suspect: Parents gather up all these heavy metals (aluminum, mercury, and more) during our 30 years or so before we have children. Then we give them these shots that are preserved with heavy metals. And for some sensitive or genetically predisposed children, those heavy metals push them over the edge into Autism Spectrum Disorder.
I'm not passionate about this because I have been personally affected by it (thank goodness). I'm passionate about it because I'm tired of the complacency. Just because not/minimally vaccinating isn't the norm doesn't mean it's wrong.
A couple of vax blogs I wrote:
http://blog.thenatureschild.com/2008/09/vaccinations-and-choice.html
http://ecochildsplay.com/2009/02/09/guarding-against-gardasil/

Lydia McCoy said...

I genuinely appreciate your thorough and articulate explanation of your struggle to decide what is best for your child. However, I also encourage you and your readers to consider much of what you read online is not factual, especially when it comes to science. Your argument can sound convincing until one remembers that you are not a medical professional, and therefore are vulnerable to misleading information in your research. For instance, the flu vaccine contains ethyl mercury, while fish contain methyl mercury. The difference between ethyl and methyl is substantial, and they react differently in our bodies, which is why you can have one and not the other when pregnant. This kind of well-intentioned but inaccurate information that permeates your post causes a lot of confusion and costs the public health sector a ton of money to clarify the science over the rumor, funds that could instead be used to purchase vaccines for families who desperately want them but cannot afford them.
Please visit our website for more information, and feel free to contact me with any questions you may have. I'd be happy to put you in touch with medical experts who are loving and passionate about keeping kids healthy.
http://www.childrensimmunization.org/

Thanks for the opportunity for discussion!
Lydia McCoy
Executive Director
Colorado Children's Immunization Coalition

Lisa C said...

Argh, vaccines. I was so pissed that I got talked into the Hep B vaccine for my newborn (with a compromised immune system, mind you!). I didn't know they did that at the hospital and was not prepared for it. When I read afterward what Hep B is, I was horrified that they would routinely give it to newborns who did not have any risk for the disease. It's things like this that make me question the vaccine industry. I have a big problem with the chickenpox vaccine, too. Having the chickenpox as a child is helpful to the immune system and soooo benign in childhood. Most childhood illnesses are much more mild in childhood. How many adults keep up with their booster shots? They forget to get their shots and then end up with a terrible illness that they could have gotten over and done with as a child. I'm not saying all vaccines are bad, but it's hard for me to trust them when the recommendations can be so illogical.

I have found the book "Raising a Vaccine-Free Child" by Wendy Lydall to be helpful. A friend of mine keeps recommending the website http://www.thinktwice.com/

Thanks for writing this article. Vaccines have been on my mind lately. I still don't know what to do because I don't know if I can trust the vaccine industry OR anti-vaccine activists. All I can do right now is go with my gut instinct.

Hobo Mama said...

Cate: Thanks for the introduction! I look forward to reading your blog posts and poking around. Yeah, I'm surprised by how little parents bother to research issues that affect their children, and just accept the norms, even when the norms change (which suggests to the rational mind that the norms are not always right!). Very interesting post about Gardasil! That's a vaccine that worried me. It seemed to be being pushed really fast, before long-term studies could be done.

Lydia, et al: First of all, I sincerely hope (and expect) that no one out there would read my one blog post and think: That's that, then — I know everything there is to know about vaccines. I hope I only spurred further and more meticulous research. This was only "things that were on my mind today," not a serious research attempt. I didn't even have the books I wanted to reference in front of me. I mostly just wanted to open up a conversation — or did I? I was afraid this topic could bring out a lot of discord. Sigh. I really hate talking about vaccinations. Really, really do.

Second of all, I agree that I should never bother trying to do math. I didn't mean to go into mercury in any depth, because I know thimerosal has been discussed to death and is being removed from pediatric vaccines (though not all flu ones). Here's a comparison of ethyl and methyl mercury filled with all the scientific lingo a body could hope for.

Excerpt: "In conclusion, both animal and human studies indicated that the pattern of tissue disposition of ethyl mercury was qualitatively similar to that of methyl mercury, with brain levels of the intact mercury being slightly higher for methyl than for ethyl. ... However, such limited evidence as now exists suggests that the rate of conversion to inorganic and, subsequently, the rate of excretion are more rapid, perhaps substantially so, compared with methyl mercury. Data on the biologic half-time of the ethyl mercury radical in body tissues, especially the brain, are essential for estimates of tissues burdens and health risk from cumulative exposure from repeated doses of thimerosal in vaccines given to infants."

Looks like more research is needed.

Here's another: "Limited data on toxicity from low-dose exposures to ethylmercury are available, but toxicity may be similar to that of methylmercury. Chronic, low-dose methylmercury exposure may cause subtle neurologic abnormalities. Depending on the immunization schedule, vaccine formulation, and infant weight, cumulative exposure of infants to mercury from thimerosal during the first 6 months of life may exceed EPA guidelines."

I don't pretend to be an expert, but I also don't trust that every expert knows everything or never makes mistakes. I continue to research, and I find that http://scholar.google.com/ is a good resource for looking up journal articles. Unfortunately, I'm not able to access everything since I don't have the money to pay for the subscription-only sites. I continually look for accessible and helpful resources. I hope that your site is a good resource for parents, and not just a tool for quieting them. I get tired of the "there, there, we know best," pat on the head I get from doctors when I raise questions. Your site doesn't seem to be terribly in-depth, though. For instance, on the somewhat patronizingly named "Fears, Myths, & Misconceptions" page, a lot of facts are thrown around with no citations to back them up.

In the end, I think we do need to raise questions. There's no point in blindly accepting everything that science throws our way. I recognize the absurdity of using science (research) to challenge what scientists are telling me, but it's the tool I have at hand. Not on topic, but as an example — nutritionists once told us that we had to stop eating butter and offered margarine as a better substitute. Only, it turns out margarine has trans fats, and now we know those aren't better at all. Science finds out new things all the time, and sometimes the new things are old things — like, as another example, sleeping with your baby serves a purpose. And yet parents are still fearmongered into not cosleeping.

I would love to see some more balanced resources that impartially look at both sides of the vaccination issues and that review all the available literature, while acknowledging the gaps that still exist in what we wish we knew about the long-term effects of vaccines, particularly the new ones on the market. That's what I appreciated about the two books I read that I mentioned in the post. I read some other books, too, but those were the ones I felt were strongest.

Did I mention I hate thinking about vaccines? Yuck.

Hobo Mama said...

Lisa: I was working away at my novel-length comment during the time you posted yours. :)

"I still don't know what to do because I don't know if I can trust the vaccine industry OR anti-vaccine activists." Thank you! As you say, argh.

I had heard good things about Raising a Vaccine-Free Child (this is it, right?), and I was disappointed not to find it at our library. I'll have to see if I can get it through interlibrary loan. I'll check out the site you mentioned, too. Thanks for the recommendations!

Susana la Banana said...

Ugh. The vaccine debate. So, so hard to come to ANY conclusive answers. I'm glad you mentioned the most important part (to me, anyway), which is that we can choose to get a few vaccinations (I'm totally with you on Hib and Rubella) and not have to get them all.

Also something you don't hear of enough, something obscured by the debates between vaccine-haters and -lovers, is that shouldn't we be always trying to improve the vaccines we have available now? But people seem to think you just have to take what you're given, or not, as the case may be. I would be a lot more likely to get more vaccines for my child if I knew they were the best that they could be.

I liked The Vaccine Book by Robert Sears. Even though he is pretty pro-vaccination, I think his approach is just the right way to think about it--take each individual vaccine on its own, and also consider each individual child's potential for needing it or for adverse reactions to it, as you mentioned.

I'm so glad to hear that there ARE actually moms who are ambivalent and not just vehement. =) Sorry I can't tell you what to do...

Susana la Banana said...

Oh yeah, and then just to confound everything even more, the things that used to be benign, like chicken pox, become more severe when you introduce vaccination, I think. Seems like I've read about that somewhere, that now more chicken pox hospitalizations happen and such. This, to me, is a VERY good argument for NOT starting NEW vaccines....or at the very least until we get it perfect. Which probably won't ever happen.

Jenny said...

I hated thinking about it, too! What I really wanted to do was stick my head in the sand and not pull it up until my daughter's one-year round of vaccines was over and done with. But I couldn't. So after our (former!) pediatrician assured me that anyone suggesting the vaccines were unsafe was just a "loony toon," I decided I'd better do my own research.

I liked the Vaccine Book. He wasn't anti-vax, but yet I came away from the book not wanting to vaccinate. I was considering getting SOME vaccines for my daughter--the most important ones. I stuck a post-it note on the page for each vaccine and wrote down the pros and cons. It turned out that the most important vaccines also seemed the most risky (or had the most unsavory list of ingredients--aborted fetal tissue, no thanks!), and the safer vaccines were to protect against diseases which were either pretty tame or extremely rare.

My daughter stays with my mom and dad when I work, and I breastfed until about three days ago (about 21 months). She is low-risk. If ever we put her in public school, or travel abroad, we will reevaluate the situation.

T. Baughman said...
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T. Baughman said...
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Taryn said...

As the mother of two selectively immunized children, I would like to respond to Lydia McCoy’s statement. I do not intend this to be a personal attack on Ms. McCoy, but I feel that her remarks are a good representation of the sentiments shared by many vaccination proponents. It seems to me that Ms. McCoy’s comment trivializes, albeit subtlety, the responsibility that parents bear as the primary decision makers for their children’s wellbeing. What I understood from her statement was that parents are vulnerable and can become confused by all of the misinformation regarding immunizations that they may encounter, a point that I do not entirely discount. But I disagree with the inference that parents are not capable of accessing and interpreting basic scientific information, leaving them unable to make sound medical decision for their children's care. The implicit conclusion seems to be that such decisions should be left to the medical professionals, a conclusion that I fully reject.

Since I have been dealing with the immunization conundrum for a few years now, I would like to remind everyone that rhetoric and scare tactics are used by people on BOTH sides of the issue. For example, the Colorado Children’s Immunization Coalition, of which Ms. McCoy serves as Executive Director, asserts:

"Vaccinations save lives.

Preventable diseases rob unprotected children of their lives. In hospital hallways around Colorado, the scene is too familiar:

A father watches as his baby boy dies of meningitis.

A two-year-old girl dies of influenza, just weeks before she was to be vaccinated.

A one-month-old baby, hospitalized with pertussis, gasps for air between episodes of coughing.

Tragically, these deaths and illnesses could have been prevented with simple vaccinations." http://www.childrensimmunization.org/

These scenarios play to the fears of all loving parents. Who wants to see their little one suffer? Unfortunately these deep-seated feelings are often exploited as a means to propel agendas of all kinds—immunizations are no exception. Following are a couple of fallacies that jumped out at me as I read through the previous statement.

1. A one-month-old baby, hospitalized with pertussis, gasps for air between episodes of coughing. Interestingly enough, the current recommended immunization schedule does not indicate that children under the age of two months should receive the DTaP vaccine. Since this is the case, how would a vaccine have helped this one-month-old baby suffering with whooping cough (pertussis)?

2. A father watches as his baby boy dies of meningitis. This one is a little less obvious, but this statement implies that a vaccine for meningitis exists. Unfortunately, this is not the case. "Meningitis" is one of those powerful, red-button words that sets off alarms in people's heads. We know that meningitis is a horrific, even deadly disease, but many people cannot tell you much more beyond that fact. According to the United States Centers for Disease Control and Prevention "Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain." (Please read more here: http://www.cdc.gov/meningitis/bacterial/faqs.htm.) There are indeed a few immunizations on the market that can help to prevent some of the common illnesses that lead to meningitis. Regretfully, there is no existing blanket vaccine that will protect a person from the myriad of possible diseases that lead to such an infection.

These are a few, of many, examples of irresponsible use of information to attempt to scare parents into making knee-jerk immunization decisions for their children before they fully understand all the benefits and risks involved. No feeling of fear should dissuade a parent from seeking out information that will help them to make informed decisions for their children's well being. Parents have a right and responsibility to do so, much to the chagrin of many vaccine proponents.

I do not discount the value of sound counsel from competent health care providers as one way of gaining understanding but I also do not think that this should be the end-all when making health decisions for our children. Physicians are largely invested in maintaining the health of the general population. Because of this public health focus, the decision to vaccinate is a cut-and-dried issue for many medical professionals. Parents, on the other hand, are responsible to make thoughtful and wise decisions for each of their children on an individual basis which makes vaccination decisions much more nuanced. While concern for the health of our communities may be a consideration, I would be willing to bet that it is not the primary focus of most parents’ immunization decisions.

I wish that the parental duty to make educated decisions for our children was championed and encouraged a bit more by the medical community and the general public. Unfortunately, in my experience, this is rarely the case. For this reason, I welcome open discussion of the issues surrounding vaccinations in the hope that they will spur conscientious parents on to further research and education. I would like to acknowledge Ms. McCoy’s concern about the risks of gathering information through internet searches alone. As parents, I feel that we need to do additional leg-work to confirm the validity of what we read online. We need to visit our public and local university libraries to access published literature and medical journal reports as we inform ourselves about the specific immunization needs for our children. While this can be a daunting task, I differ from Ms. McCoy's stance in that, I do believe that parents are capable of wading through the ocean of misinformation and rhetoric thrown at us from both sides of the vaccination issue. I feel confident that most parents who have the desire to educate themselves about vaccinations are not ignorant, dough-heads. Rather, they diligently strive to come to well-informed, intelligent and sensible conclusions that can help to maintain the health and wellbeing of their children.

Taryn said...

http://online.wsj.com/article/SB123328106104931919.html

This is a Wall Street Journal review of an episode of the PBS program "American Experience" that focused on the development of the polio vaccine. I have not seen it, but it looks interesting.

In light of my previous comment I thought that this excerpt if the article/quote by Basil O'Connor was interesting:

"The scientific push to find a cure [for Polio] was made possible by an even earlier crusade, led at Franklin Roosevelt's request by his former law partner Basil O'Connor. Although O'Connor spent the next three decades campaigning against polio, his single most effective creation was the March of Dimes -- which turned ordinary Americans into mini-philanthropists.

Yet this "fund-raising gold mine," as someone calls it here, came with some imperatives, including the hype factor imbedded in appeals for many causes today. The key for O'Connor was to make Americans forget that many other diseases, including cancer and TB, were far more prevalent, and deadly, than polio. Ultimately, the documentary explains, O'Connor discovered that "the best way to raise money was to scare the hell out of the American public" by pretending that a relatively uncommon disease was about to get them."

An effective approach.

Hobo Mama said...

Susana La Banana: That's what I keep thinking about chicken pox. Why push it off to later in life, when it's more dangerous? Of course, some would say that the vaccine will completely eradicate it, so it won't matter. But that still gives a generation or two or more a window of increased risk. (In other words, my kid's generation.)

Jenny: Thanks for the recommendation for the Vaccine Book. I'll look for it at the library.

Taryn: Thanks for the thoughtful response. You've really articulated well the responsibility parents must take in making informed decisions for their children, and the dilemma of trusting public health authorities vs. doing one's own research.

Slightly tangential, but some researchers think FDR might not have had polio at all. I'm wondering what that means about the apparent prevalence of polio, if some cases were being misdiagnosed. Well, anyway, no way to confirm it now!

Lydia McCoy said...

Taryn, I truly appreciate your frustration and irritation with scare tactics from both sides. The public health community certainly hasn't figured out exactly how to express our concern for the spread of disease to younger generations (of which I am a member) who have never seen the disease because of the success of vaccination. It is really a conundrum. I think a friend of mine put it best when she talked about asking her mom about vaccination, and her mom said, "Are you crazy? Do you know what those diseases did to my friends and family?! The whole reason they don't exist is because of vaccines!"

Some moms are under a false impression that diseases like measles and whooping cough are just not a threat anymore. The reason we try to remind parents of the severity of these diseases is because we want them to be encouraged to protect their kids, not only for their child's sake, but for the kids they play with and the community as a whole. We are fighting a very vocal, and highly emotional anti-vaccine group that uses fear without regard for moms' nerves. And we have science on our side- sexy. It's a tough battle! And sad because a lot of public health advocates are starting to get exhausted and feel like, "Well, there will be a significant outbreak of disease, and then people will get scared again and understand the importance of vaccination." And that statement is soul crushing for them because the reason they chose this field as a career is to protect people from illness. No one wants disease outbreak, so we try to prevent it.

Any suggestions on how we can protect our communities from disease by spreading facts about vaccination would be greatly appreciated! We don't want our website to be a turn-off, we want it to feel like a safe place parents can get trusted info. It is just so hard to convince people to protect themselves from something they don't see as a threat, even though there is a very real threat that if the anti-vaccine and semi-vaccine movement takes off diseases will come back. They are not eradicated in the US. (except Small Pox- yay!)

I very much appreciate the opportunity to join this discussion with you all. I have had it many times with people I love and care about. It's tough to be the lead decision maker for your child's health. Clearly you all want the best for your children, and I wish you all the best!

Anonymous said...

Sorry folks - its a jungle out there.

The public health sector are their own worst enemies because of the attitude they have to non-scientifically trained civilians. They are convinced of the benefit of vaccination but don't have the vocabulary to actually win the argument - hence the normal screaming match you see here.

The maths says that much of the benefit of vacines is a herd benefit - you remove the reservoir of disease in the population so the chances of those who might not be immune for whatever reason or who might suffer badly if they get the disease of actually catching it are much smaller. And that is just about it. So...its probably of marginal benefit to your child being immunised but a much bigger benefit to everyone else (what economists call an externality) Result: well informed middle class parents dont get their kids immunised and the population as a whole is slightly worse off as the reservoir of disiease gets a bit bigger.

Now you can make exactly the same argument for voting in the election - in a big election the chance of your vote making a difference is minute so a logical person would stay at home and watch TV. However, people do vote for all kind of reasons (not least that it is the only chnce you get to tell politicians how much you hate them) but mainly as part of a civic duty thing and you should regard vaccination as the same thing unless there is a very strong reason not to.

molly said...

Hobo Mama - As I read your process for making your own vaccination decisions it was like reading my own story (only more well-written.)
You have inspired an excellent discussion.

I thought it was interesting that Lydia brought up the dangers of measles. In my research over the last few days I have come to the conclusion that not only will I pass on the vaccine for measles, but I will welcome the illness as I would chicken pox - hopefully after the age of three and long before puberty. The incidence of certain cancers and other health problems are significantly reduced from the body overcoming the illness and vaccination does not provide these benefits.


I also challenge her to provide studies that indicate that outbreaks are eminant from a decrease in vaccination.

Also, your comment that "And we have science on our side - sexy." is not only demeaning to the discussion, it is questionable at best.

Hobo Mama said...

Molly: Thanks for your comments. Measles is definitely an interesting one to point out. I remember my mother talking about how she'd been able to pass on to me a temporary passive immunity to measles during pregnancy and breastfeeding because she had had measles as a child herself -- but that I, having only been vaccinated, would not be able to afford the same protection for my newborns.

This might be funny only to me, but I read your first sentence wrong and thought you said my post was like your own story, only yours had been more well-written. And I thought, Well, that's fair.

Hobo Mama said...

Oh, I forgot one more thing I was going to mention to Jenny: I'm reading The Vaccine Book by Sears now. You're right that, even though it's written from a pro-vax perspective, it's not inflammatory or condescending. I'll have to do a review of it when I finish. I'm having the same experience of taking his evidence for getting the vaccines and coming to the opposite conclusion for most. I'm still undecided about a couple (pertussis, mostly), now that Mikko's in day care. Still plugging away with the research!

Bibliomama said...

I've just been reading some of your posts and when I saw that you didn't vaccinate I looked for the 'why we didn't vaccinate' one. I'm so impressed by how balanced and non-cuckoo you are. I don't agree with some of your points, but I really appreciate your -- and your readers' -- lack of stridency and judgement against others. Way to raise the tone of the debate.

Hobo Mama said...

Thanks, bibliomama! I disagree with my self here and there, too, so that's fine. I'm curious what your perspective is and if you have any blog posts yourself on the subject. I'm still researching and pondering so always love to hear other people's thoughts.

Cassie said...

I actually wanted to read about your opinion about vaccines so I did a search through your blog about it.
We got all the recommended vaccines up until 6 months. I didn't know any better, well, I didn't know anything. I thought that's what you did. But at the 6 month appointment, I was like, I don't even know what any of things are that are going in to my son!! So, for 6 months (well really just a couple months before his scheduled appointment), I read and researched before his one year appointment. Luckily(not really luckily) he was sick right before his appointment so it was a good excuse not to get them. And I keep reading, and sometimes I'm scared into thinking he needs them, but more than often I keep wondering why the are necessary. And really, now I don't have that much left. (except big ones like MMR, which scares me to get) So now we don't even know. I think I need to get those books you mentioned. I have the Dr Sears one but I want to read the other two because they are so commonly mentioned. But I feel like I have so many books to read and vaccines are so opinionated... blah.
So anyway, thanks for your insight.

Momma Jorje said...

When I first faced this decision 13 years ago, I did note that clinics always have you sign the form that SAYS they gave you the insert from the manufacturer, but they NEVER seem to give it to you! SO - I contacted all the manufacturers and had them send me the inserts!

As if the insert for ANY drug wasn't scary anyway, right? I decided one vax at a time. I was uncertain about the pox vaccine and discussed it with my lactation consultant. She had concerns about ties between the vax and shingles later in life. Her doctor didn't have any answers for her, so she chose not to do that one.

I don't vax. At all. I am not likely to research the vaccines again for Sasha or a future child, even though so much time has passed. I felt comfortable with my decision. Comfortable enough to argue against my oldest daughter's father.

My mother played devil's advocate with me to make sure I'd considered all the angles. She put it well into perspective this way (in regards to arguing with Tyler's father), "if you don't vaccinate and Tyler DIES because of it, are you prepared for what that will do to your relationship? Are you prepared to be wrong?"

I was. Though now I'm divorced anyway. Sasha's father didn't question my stance at all. He knows I've researched it and have parenting experience. We don't vax.

Momma Jorje said...

I also wanted Tyler to get the chicken pox, which seems kind of silly. My sister had a preemie and a friend at a university offered to inject him with the pox (for the mildest reaction) so he could gain natural immunity. We planned to have a pox party, but it never happened.

Tyler's pediatrician tried to tell me that if I didn't vaccinate and Tyler got sick and made one of the other patients sick, I would be morally responsible! Um... aren't you referring to other VACCINATED patients?? Why would they get sick if they're vaccinated? Ugh.

Lauren @ Hobo Mama said...

@Momma Jorje: So glad to hear your perspective. Also glad to hear you're not conflicted, since I still am but don't want to be. It is odd how up in arms the pro-vaxers get about non-vaxers — if vaxes work so well, then there shouldn't be so much fear and vitriol.

I've been hoping Mikko will catch the chicken pox naturally, but I'm not averse to playing with poxy friends if we can find some. Otherwise, I'll have to reevaluate when he's nearing puberty.

Adrienne said...

I see that this is an old post, but I just found it. I'm right where you were when you wrote this. I'm reading that book--What Your Doctor's Don't Tell You...and read the one by Dr. Sears. We're still so unsure. We just keep putting it off as well. Burkley is now 8 months and hasn't had anything other than the Hep B at the hospital (he was born premature and we were not ready at all for making these decisions!) though he hasn't had any of the follow up doses. I just feel stuck and my doctor, like your naturopath, just says we can do it when we're ready, but hasn't offered any of her own thoughts. I'm going to press her a bit more though, at his 9-month appointment. We plan on extended breastfeeding as well as homeschooling and I'm not sure how that needs to be calculated into the decision as well because we do have playdates and church and other times where he's in the church nursery...ugh, I'm just so unsure. Anyhow, I just wanted to check in and see if you've made any decisions since posting this.

Stardust said...

I read through the top few comments on here and there are for sure some good ones. I thought I'd throw in my observations as a health care professional. Note, I am not a doctor or nurse but a CNA which means I spend a lot of time observing and talking to doctors, nurses, patients, and families in a wide variety of settings but don't have medical agendas myself and this is what I've seen:

The staff in the hospitals that pressure you to get all sorts of shots? (Have pinned me down and stuck me with shots as my loving coworkers) They don't get shots themselves or for their families. Or they don't get all the shots anyways. H1N1 and the flue were going around and half the nurses got the shot for one and the other half got the other but I didn't know anyone who got both except all their patients. Ha. Many of them have concerns about new vaccines that were pushed through too quickly to treat outbreaks like H1N1, or other concerns, despite being in a high risk category exposed to sick people all the time.

When I think of vaccines, I think of a patient I had who was that little girl who couldn't get vaccines herself but was very vulnerable to every possible complication from those diseases due to her medical issues. For her and her family's sake I want everyone in the world around them to be thoroughly vaccinated against everything possible so she doesn't die from the flue or from whooping cough or the chicken pox.

I've also had that patient who was 50+ before she got her first flu shot and lo and behold was predisposed to MD and is now in an electric wheelchair. Terrifying.

I think I'm rather a fan of delaying and spreading out vaccines - I'd rather not pump the fragile little one full of drugs on their first day of life, but gradually over the next couple years, I think getting some of those shots in order of the importance you see with your doctor you trust is probably a good thing. Maybe ask your doctor what vaccine she would most recommend/not recommend and why since she's not giving it away without a direct question it seems. You've already found some seem much more worthwhile than others. Like tetanus - super serious if you get it, not a big deal if you have the vaccine, and lots of scary ways to get it. Can't be undone once you have it. That's probably a pretty well established vaccine too - not like the ever changing epidemics.

Personally, I am delighted my parents and my husbands parents gave us the whole run of HPV vaccines when we were 14 as we tell my doctor that (plus being monogamous in a life-long sort of way) and she says, "oh wow, I guess you really don't need annual exams then!" and I am delighted. Oh so delighted to skip the cold metal duck-lips for a few years. A vaccine that regularly benefits my life in a little way, other than preventing cervical cancer.

I like the idea of funding someone else's vaccines if you're not to stoked about them for your own kid and have the luxury of giving someone else in perhaps a higher risk situation the opportunity to choose. Also it's a bit like vaccinating your children through a surrogate.

I've been enjoying your site greatly as I dream of babies. Thanks :)

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